Aji Varghese

Patients in the intensive care unit (ICU) are known to have highly fragmented sleep, with a disturbed circadian pattern, shortened overnight sleep hours, drastically enhanced stages 1 and 2 sleep and limited or non-existent deep sleep. In order to maintain patients' biological circadian rhythms, sleep should be prioritised during the day and night. Thus, to minimize the impact of sleep interruptions and exhaustion in ICU patients, a comprehensive strategy that includes assessment of sleep problems and lethargy, environmental controls, appropriate pharmaceutical management, and educational and psychological interventions is required. This review article focuses on the impact, causes, risk factors and management of sleep deprivation along with interventions to promote the sleep quality.

Diabetes mellitus is a disease that affects the way the body produces and uses insulin to control blood sugar. Basal bolus insulin therapy is a combination of short and long acting insulin. But, now a days there is a deadline in this therapy due to the use of automatic insulin pump and continuous glucose monitoring. It reduces A1C without any risk of hypoglycemia. This article review regarding role of basal bolus therapy in diabetes and in depth understanding of DDT including its dose calculation

Complementary and alternative medicine (CAM) refers to a wide range of clinical therapies outside of conventional medicine the term “complementary “ refers to  the therapy that are used in conjunction with conventional medicine where as alternative medicine includes therapy that are used in place of conventional medicine. The term “integrative medicine that has been advocated by some CAM providers More than one-third of patients with diabetes in the united state use some type of complementary and alternative medicine herbs, dietary   supplements and mind body medicine are the most commonly used studies and CAM modalities to treat diabetes including proposed mechanisms a summary of evidence and adverse effect. It also offers recommendation for counseling patient regarding CAM use. The use of CAM for patients with diabetes was reported to be common in almost all parts of the world However, different definitions were used for CAM, which was one of the reasons for a wide range of prevalence of CAM use ranging from 17% to 73% CAM use prevalence in the USA ranged from 31% to 57% among diabetes patients , 63% in Bahrain 62% in Mexico 7% in UK  and 25% in Canada  China had a long tradition of use of herbal medicine for diabetes The findings of a systematic review reported that Chinese herbal medicines were reported to be more effective for diabetes compared with lifestyle modification alone  In China, traditional medicines accounts for 40% of all healthcare.